A young child arrives at the hospital emergency room in respiratory distress, his asthma worsened by smoke exposure. An elder has uncontrolled blood pressure because there wasn't time to get her medications when the evacuation orders came through. Scabies and other illnesses related to crowding spread quickly through the close quarters of the evacuees. Sudden departure from, and worry about home, bring significant mental stress.

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These sorts of health problems are commonplace for people in circumstances like the over 13,000 northern Saskatchewan residents forced to leave their homes due to forest fires.

As physicians, we're taught not only to look at the symptoms of an illness, but to seek its root causes. For these patients, the connection is fairly obvious: through smoke and relocation, the fires have hurt their health. And the cause of those fires? Canadian experts are pointing to high temperatures and dry conditions, with climate change a likely factor.

The people who have been relocated in Saskatchewan come from northern communities with higher rates of poverty than the rest of the province. This is the predicted pattern of the repercussions from climate change, as remote communities with less infrastructure are more prone to its effects. Poverty, lower rates of employment, the effects of colonization and other social determinants also lead to higher rates of illness. This means that community members are more susceptible to the health effects of changes in temperature, air quality and diet that come with the disruption of climate.

We now have internally displaced people in Saskatchewan, and although they do benefit from state protection, in some ways they are as vulnerable as resettled refugees. The federal response to the forest fire crisis is certainly better, however, than the treatment refugees to Canada have received in recent history, as exemplified by the cuts to the Interim Federal Health Program, reducing health services to this vulnerable population.

Natural disasters can bring out the best in our political leaders. They come forward with extraordinary support for people affected or displaced by floods or forest fires. We've seen this in the past couple of weeks in Saskatchewan, too, as provincial and federal governments have been assisting evacuees and adding additional resources to fight the fires devastating the North of the province.

This action is admirable, a manifestation of the care we provide for each other as a society, and of governments and civil society acting decisively in the public interest.

Tragic times can paradoxically be a boon for political leaders. It's a chance for dramatic speeches and fire station photo ops from government and opposition leaders alike. We say this not to cast doubt on their motivations. A strong performance in times like these demonstrates the dedication the public expects from their elected leaders. However, we should be able to expect more.

The point is that talking about climate change is not bringing up politics in a time of tragedy. There are already politics at play. What we need from our leaders is more than a robust response to the downstream effects of climate change. For the health of Canadians, we need to see upstream thinking to prevent this from occurring over and over.

Unfortunately, we're hearing nothing of the sort. Quite the opposite in fact; at the same time as the federal government is stepping in to take action to respond to the effects of climate change, they are the subject of international criticism at the Climate Summit of the Americas in Toronto for their inaction on its prevention or mitigation. Premier Brad Wall has been openly resistant to taking any meaningful action to reduce carbon emissions, despite Saskatchewan leading the country in per-capita carbon output.

Natural disasters can bring out the best in our political leaders

Climate change is a massive and complex issue. It can be hard for people to get their heads around, and hard to motivate political leaders to make sacrifices to act. Sometimes what it takes to understand something on this scale is to see its effects on the health of a single person or a community.

Saskatchewan has had thousands of climate refugees suffering as a result of climate change. Will that be enough to change minds and spur meaningful action? If our leaders have, as they should, the health and well-being of the population as their highest priority, it must.

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Ryan Meili is a family physician in Saskatoon, founder of Upstream, and an expert advisor with EvidenceNetwork.ca.

Mahli Brindamour is a pediatrician in Saskatoon and a member of the steering committee of Canadian Doctors for Refugee Care.